In Sioux Falls, South Dakota, teachers are the first line of defense in identifying and treating mental health problems for teenagers. If a student is acting withdrawn, or displaying some other shift in behavior, school faculty are empowered to “flag” the student as one who may need help.
A “flagged” student is then referred to their school’s counselor. Students can meet with a counselor up to six times before the school gets in touch with the student’s parents.
Once consent has been obtained from the parents, the school refers the student to community services such as Southeastern Behavioral Health, and they are screened in an attempt to work towards a diagnosis, so proper treatment can be given.
This is how it is supposed to happen.
Unfortunately for teenagers in Sioux Falls, however, it is rarely how it does happen.
There are a number of limiting factors for these adolescents.
First of all, to move past the meetings with the school counselors, parents must participate in a dialogue about their child’s mental health, and consent to further screening and treatment. This can be difficult because of parents grappling with mental health stigma, or because the parents are working multiple jobs, or incarcerated.
Second of all, struggles like the cost of treatment, the time consumption of getting to, waiting for, and getting from treatment, and dealing with insurance or lack thereof, can all prevent families from pursuing treatment.
Finally, there is, of course, the social stigma surrounding mental health. In a survey of over 1700 adults in the UK, it was found that the most commonly held beliefs were that people with a mental illness are dangerous, difficult to talk to, and that some mental illnesses such as eating disorders or substance abuse struggles are self inflicted (Davey 2013).
An expert in a 2001 task force that investigated the gap between those who need mental health treatment in South Dakota and those who actually receive it estimated “the number of kids who needed and qualified for treatment was more than twice the number receiving help.” The report added that South Dakota’s mental health care system was “falling short in its ability to effectively meet the needs of children” (Anderson 2017, p.7).
To remedy this failure, the task force recommended a seven-point plan that called for” better coordination among agencies, improved screening in schools and daycares, a public education campaign and more money for counseling and other services” (Anderson 2017, p.20).
South Dakota does have a network of community mental health centers, like Southeastern, which are nonprofits that are state funded and regulated. These mental health centers are required by state law to serve those with diagnosable mental illnesses, and provide “a seamless continuum of services” when support is needed as part of patients’ recovery” (Anderson 2017, p.18).
However, for D.J. Hilfer, that has not been the case.
D.J. once saw a therapist at Southeastern, but when that therapist relocated and D.J. did not connect with their replacement, his mother requested someone new. Since then, D.J. has been without care from Southeastern, and without any written notice about the cessation of service, despite the center’s policy to provide this notice 72 hours before such cessation.
D.J. is just one example of the many adolescents who slip through the cracks of the system, despite the supposed cut and dry, pipeline policy that has been designed– and a lucky example at that. D.J. has a support system in his family, and has learned coping mechanisms for his struggles.
Many of these teenagers have neither. In 2015, South Dakota had the third-highest rate of suicide among 18-24 year olds, and the fifth-highest rate of children in juvenile detention (Anderson 2017). These teenagers need help– and the system that is meant to help them is still falling short.
For more on this topic, please read, “Mental health screening misses kids in need in South Dakota.”
Anderson, P. (2017, July 24). South Dakota’s Invisible Crisis: Regional care centers not serving most kids. Retrieved August 12, 2017, from http://www.argusleader.com/story/news/2017/07/21/south-dakotas-invisible-crisis-regional-care-centers-not-serving-most-kids/488215001/
Raposa, M. (2017, August 11). Mental health screening misses kids in need in South Dakota. Retrieved August 12, 2017, from http://www.argusleader.com/story/news/2017/08/11/invisible-symptoms-make-mental/556773001/